CONDUCT OF FILM ANALYSIS

For midterm

Topics to be covered Repeat Analysis Analysis Of Reject Versus

Repeated Films Determination Of Rejection

Rate Distribution Of Rejected Film Guide To Good Practice

The desired outcome of a diagnostic x-ray study is the

creation of an acceptable diagnostic image, a correct

diagnosis, and the satisfaction of all internal and external customer.

Quality control testing can only minimize the risk of obtaining sub-quality images but cannot prevent them entirely.

Quality management program must also include looking at the final outcome of a diagnostic x-ray procedure and determining the quality of outcome to see if further improvement can be achieved.

Outcome assessment Repeat analysis of images Artifact analysis of images Accuracy, sensitivity and

specificity analysis of diagnosis.

Repeat analysisIt is a systematic process of

cataloging rejected films and determining the nature of the repeat so that repeat images can be minimized or eliminated in the future

Importance of repeat analysis It provides knowledge of data about:

Equipment and accessory performanceDepartmental proceduresSkill level of the technical staff

With this knowledge, solutions can be found to minimize repeats and also document the effectiveness of quality control and quality assurance protocols

Advantages Repeat analysis can show how many

repeats in the depart w/c in turns address the party concerns of what are the problems.

With lower department repeat rates:Improved department efficiencyLower department costLower patient doses

Improved department efficiency With number of repeats are kept low, the

amount of time that patient must spend undergoing diagnostic procedures decreases.

This in turns increases patient satisfaction and allows the department to service more patients in the same period.

Lower department costs When the number of repeats

are reduced, the costs associated with film, processing, labor and depreciation of the equipment decrease significantly.

Lower patient doses Images that are

unacceptable results in the repeat of the particular view, which means that the patient must be re-exposed to ionizing radiation.

Causal Repeat rate In repeat analysis studies performed on

departments without quality control procedures for the darkroom, processor and equipment, 75% of all repeats were caused by improper optical density of film.

With quality control protocol in place, studies shows that most repeats are results of positioning errors.

National average of repeat causes for departments with quality control proceduresCategory % RepeatPositioning 30Light films 14Misc. (artifacts) 14Darkrooms 11Black films 9Tomography scouts 8Fog 5Patient motion 5Mechanical problems 4

Repeat analysis For a study to be done, a

worksheet for radiographic imaging departments should be used, so that the proper statistical information is obtained and recorded.

Worksheet A worksheet should include the

radiographic procedures performed in the department, along with the possible causes of rejection, such as positioning, overexposure, under exposure, motion, artifacts, and miscellaneous causes

Causal repeat rate The causal repeat rate is the percentage

of repeats from a specific cause and is calculated with the following equation:

Causal repeat =

rate

Number of repeats for a specific cause

Total Number of repeatsX 100

Example A total repeat of a department has 200

films in a month, and 90 out of 200 films are the result of positioning errors.

So the percent of repeats caused by positioning error is 45% of the total repeat films.

Total repeat rate The total department repeat rate is

determined with the following equation:

Total repeat rate =

Number of repeat films

Total number of views takenX 100

Example If a department has a total of 2300 views

during a month and has incurred a 300 rejected film.

A 13% percent the department has incurred in a month

Department repeat rates should not exceed 4% to 6% and should be less that 2% for mammographic procedures.

Any department exceeding 10% to 12% should be examined seriously, because of inefficiency and contribute to high patient dose.

LABORATORY WORK

For a department to evaluate its efficiency a worksheet should be used for any repeat film.

As a QA/QC officers a worksheet can aide in identifying problems if it is mechanical/technical or by human errors.

Laboratory Exercise Instruction

Each group are assigned with a number of films.

Analyze the films.After analyzing the films, the film should be

rotated to other groups for analysis.

Survey period to location repeat

category examinati

on

Position Over-exposed

Under-expose

Motion Artifacts Other Total %

UGI 12 4 3 1 5 8 33 23%Ba. Enema

15 1 1 20 3 1 41 28%

IVP 5 2 3 1 7 1 19 13%OTHER 10 1 3 11 25 1 51 35%TOTAL 42 8 10 33 40 11 144

% 29% 6% 7% 23% 28% 8%

Total films

viewed

1320 Total repeat

144 Total Repeat Rate 11%